Indian journal of cancer最新文献

Background: The impact of surgical compliance on survival outcomes in patients with Ewing sarcoma (ES) is unclear, so this study was performed to explore the association between them.

Methods: We used the SEER*Stat software (version 8.3.6.1) to extract information on ES patients from the SEER database. Patients were divided into two groups based on their adherence to surgical recommendations: the surgical compliance group and the surgical noncompliance group. Categorical variables were expressed as percentages. Multivariate logistic regression and Chi-square test were used to explore variables related to surgical compliance. Univariate Cox regression analysis was used to initially select potential prognostic factors, and then the factors selected in the univariate Cox regression analysis were further analyzed in a multivariate Cox proportional risk model to ultimately determine the risk prognostic factors significantly related to the survival of patients with ES.

Results: Multiple logistic regression analysis suggested that adults (OR = 0.373, 95% confidence interval (CI): 0.164-0.849), Grade IV (OR = 0.373, 95% CI: 0.164-0.849), and unmarried patients (OR = 0.568, 95% CI: 0.339-0.954) were more inclined to accept surgery recommendations, while patients from 2001 to 2010 were less compliant with surgery. Multifactorial Cox regression analysis suggested that surgical compliance was an independent prognostic factor for patients with ES. Through the Kaplan-Meier survival curves, we could clearly observe that the overall survival was higher in the surgical compliance group than in the surgical noncompliance group. Furthermore, subgroup analysis also reached similar conclusions.

Conclusion: In this study, we found that surgical compliance was an independent predictor of patient prognosis. Furthermore, we found that age, tumor grade, year of diagnosis, and marital status may be related to surgical compliance.

Background: Several studies have indicated the benefits and safety of Endostar in combination with chemotherapy, but the exact real-life safety of Endostar is poorly known. This study aimed to assess the safety of Endostar in combination with chemotherapy in a real-life setting in China.

Materials and methods: This was a retrospective study of patients treated with Endostar combined with chemotherapy from January 1, 2006, to December 31, 2017. Data were obtained from the Hospital Information System (HIS). Laboratory abnormalities were evaluated according to Common Terminology Criteria for Adverse Events, Version 4.0. Bleeding events and wound complications after surgery associated with Endostar were evaluated.

Results: Finally, 825 patients were included. No patients used Endostar alone. Anemia occurred in 74.5% of the patients, thrombocytopenia in 29.0%, abnormal white blood cell counts in 54.5%, abnormal liver function in 13.8%, and increased creatinine in 1.2%. No definite bleeding events and wound complications associated with Endostar were found. Most laboratory adverse effects (AEs) were found in Grades 1 and 2. Lung cancer, osteosarcoma, and doxorubicin-based chemotherapy were associated with an increased risk of Grade ≥3 abnormal white blood cell counts. The total dose of Endostar was not associated with severe (Grade ≥3) thrombocytopenia and abnormal white blood cell counts.

Conclusion: The occurrence of AEs during Endostar and chemotherapy treatment differed across different tumor types and chemotherapy regimens. No new unexpected Endostar-related AEs were observed. The total dose of Endostar was not associated with an increased risk of severe (Grade ≥3) thrombocytopenia and abnormal white blood cell counts when used in combination with chemotherapy in the real-life setting.

Background: Duodenal neuroendocrine tumors (D-NETs) are rare but clinically significant tumors that can occur in various parts of the duodenum, including the duodenal papilla. Endoscopic submucosal dissection (ESD) has emerged as a minimally invasive treatment option for D-NETs, offering potential advantages in terms of tumor removal and postoperative recovery. We aimed to retrospectively analyze the clinical characteristics and prognosis of ESD for D-NETs.

Methods: A total of 26 cases of duodenal neuroendocrine tumors (27 lesions), including duodenal papillary neuroendocrine tumors, were studied retrospectively.

Results: A total of 26 patients with D-NETs (27 lesions) were pathologically diagnosed, and 27 lesions were found by chance during endoscopy. The lesions included duodenal bulbar, descending part, and duodenal papilla. Nineteen tumors were <1 cm (70.4%) in diameter, and eight tumors were 1-2 cm (29.6%) in diameter. There were five cases of duodenal papilla NETs. G1: 24 (88.8%) and G2: 3 (11.1%). Endoscopic ultrasonography showed that 27 lesions were confined to the submucosa. One case was a neuroendocrine tumor 2 mm inside a tubular adenoma at the papilla. All operations were performed by senior doctors in the department. The total resection rate was 100%, and the incidence of intraoperative bleeding and perforation was 0. Delayed bleeding and perforation were 0. The shortest operation time was 25 min, and the longest was 70 min. Burning tumor cells at the basal resection margin were noted in 11 lesions, necessitating careful pathological assessment. There were 24 cases of G1 type and 3 cases of G2 type. All 26 patients underwent abdominal CT before operation to confirm the absence of lymph node and distal metastasis. One patient with papillary lesion had positive lesion base resection and was treated with additional operation. Temporary biliary and pancreatic duct stents were placed before or after ESD in all five cases of duodenal papillary lesions, and no biliary and pancreatic complications occurred after surgery. Postoperative follow-up gastroscopy and abdominal CT confirmed no recurrence or metastasis during a follow-up period of 3 months to 4.5 years. There was no recurrence or metastasis during a follow-up period of 3 months to 4 ½ years.

Conclusion: ESD may be an effective and safe intervention for D-NETs ≤20 mm confined to the mucosa or submucosa of the duodenum, including the papilla. Clinicians should remain vigilant about potential complications during and after surgery. Duodenal ESD treatment NET has high requirements in terms of treatment technology, and clinicians should pay attention to the potential complications of ESD during operation.

Background: Postoperative pulmonary complications (PPCs) are defined heterogeneously and have major adverse effects in increasing morbidity. Oncosurgeries themselves are complex, are of long duration, and extensive handling of body tissues occurs in them, leading to various complications including PPCs. So, we conducted this prospective study intending to find the incidence and risk factors for PPCs in patients undergoing major oncosurgeries.

Methods: This prospective observational study was conducted after obtaining institutional ethical approval in patients undergoing major oncosurgeries. The demographic, preoperative, and intraoperative details were noted, and patients were followed in the postoperative period for the occurrence of PPC till discharge. Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score was used to predict the occurrence of PPC. Data were analyzed using multivariable regression analysis for the risk factors, and the Chi-square trend was used to see the trend of PPC with the change in ARISCAT score.

Results: The overall incidence of PPC in patients undergoing major oncosurgeries was 28.05%. The most common PPCs were respiratory insufficiency (19.2%) and atelectasis (17.6%). The highest incidence of PPC was found in thoracotomies (41.6%), followed by cytoreductive surgeries (40.6%). The risk factors for PPCs included body mass index (BMI) <18.5 or >25 kg/m2, smoking, use of nasogastric tube, age >60 years, and albumin <3.5 g/dL. Patients with low ARISCAT scores had a low incidence of PPC compared to those with high and intermediate ARISCAT scores.

Conclusion: The incidence of PPC in patients undergoing major oncosurgeries was 28.05% in our study. The independent risk factors for PPC in oncological surgeries were BMI <18.5 kg/m2 or >25 kg/m2, use of nasogastric tube, age <60 years, serum albumin <3.5 g/dL, and smoking.

Background: Cancer susceptibility candidate 2 (CASC2) was found underexpressed in multiple types of human malignancies. However, the specific role of CASC2 in AML remains uncertain. The purpose of this study is to explore the expression of CASC2 in patients with AML and healthy donors and its prognostic significance in AML.

Methods: Total RNA was isolated from bone marrow samples or peripheral blood samples of 87 patients with AML and 26 healthy adult donors. The expression of long noncoding RNA CASC2 was detected by quantitative real-time polymerase chain reaction. The association between CASC2 expression and other clinicopathological factors as well as its prognosis significance were analyzed.

Results: The peripheral blood mononuclear cell (PBMC) expression level of CASC2 in AML was significantly lower than that in the healthy control cohort (P = 0.0048), and in the bone marrow samples, CASC2 was significantly upregulated in patients with AML after the achievement of CR (median value: 0.041, range: 0.015-0.064) compared with that at newly diagnosis (median value: 0.017, range: 0.008-0.041) (P = 0.002). The expression of CASC2 had a significant relationship with complete remission (P = 0.019). Survival data assessed by Kaplan-Meier curves showed that patients with lower CASC2 expression had shorter overall survival and disease-free survival than patients with higher CASC2 expression. Finally, Cox proportional hazards analysis demonstrated that CASC2 was an independent prognostic indicator for both OS (P = 0.013) and DFS (P = 0.001) of AML.

Conclusions: LncRNA CASC2 may serve as a new molecular biomarker for the early diagnosis and of AML, and may be an independent prognostic factor affecting the survival of patients with AML.

Abstract: Chronic myeloid leukemia is a myeloproliferative neoplasm which can present in chronic phase, accelerated phase, or blast crisis. Most of the children present in chronic phase. Tyrosine kinase inhibitors are used as a targeted therapy. Few children progress to blast crisis on therapy. The blast crisis occurs in the marrow. Very few cases are reported in adults with isolated central nervous system (CNS) blast crisis. Here we are reporting a rare case of isolated CNS relapse in a child.

Abstract: Giant basal cell carcinomas (GBCCs) represent only 0.5-1% of all basal carcinomas and are known to occur and behave differently than other basal cell carcinomas. We report a 93-year-old gentleman with GBCC of the back of superficial spreading histological type who we treated with radical radiotherapy with excellent local control. Nonaggressive histological subtypes of GBCC particularly the superficial type can be well managed with radiotherapy, especially in the elderly, and should be adequately utilized in carefully selected patients.

Background: Distress is an unpleasant emotional feeling of uneasiness, sadness, worry, anger, helplessness, or guilt and is considered as the sixth vital sign of cancer. Understanding and managing distress at an early stage helps the patient to deal with cancer in a better way. The objective of the study is to estimate the pattern of distress among cancer patients assessed during new patient counseling and its association with demographic factors.

Methods: This is a cross-sectional retrospective study conducted by reviewing the case record forms of patients for a period of 4 months. The study included cancer patients between the age of 18 and 75 who attended new patient counseling and reported a score on the NCCN distress thermometer. Those with incomplete information and history of known psychiatric or neurological disorders were excluded.

Results: Among the 348 patients, 39.9% had a distress score of 4 or above, which is clinically significant distress. Nearly 75% of them reported that their distress has a psycho-social reason, and 25% reported that distress is due to physical reasons. Analysis of the association of gender and age with clinically significant distress revealed that women and younger age groups had higher distress. In our study, Christians had a higher association with clinically significant distress.

Conclusion: More than one-third of the patients reported to have clinically significant distress. This emphasizes the key role of distress screening and new patient counseling in an oncology setting. This also stresses the need for a psychotherapeutic approach in managing psycho-social concerns of cancer patients.

Introduction: Afatinib, a second-generation EGFR TKI, was approved in 2015 for the treatment of metastatic NSCLC in India. We aimed to evaluate the clinical outcomes of Afatinib therapy in a real-world setting.

Patients and methods: Electronic medical records of 43 patients who received Afatinib for advanced EGFR-mutant advanced NSCLC were retrospectively reviewed. In total, 43 patients were analyzed of whom 31 received Afatinib in first-line therapy.

Results: The patient population was younger than Lux-Lung 3. Median PFS was 15.03 months with 95% CI (7.8-18.3 months). At 14% maturity OS was not reached. However, 95% CI lower limit was 34.9 months. The most common adverse reactions were skin rash and diarrhea which were managed with dose alteration without compromising efficacy.

Conclusion: Currently, there are multiple first-line strategies to manage advanced NSCLC in India including EGFR TKIs. To the best of our knowledge, this is the first real-world study published from India which looks into the efficacy of Afatinib in advanced NSCLC. Afatinib showed a manageable safety profile and comparable efficacy in real-world practice compared with those described in previous studies.